Kotelchuck, Shana
Kotelchuck, Shana is an sole proprietor health care provider with primary practice located at 11 S Main St , Randolph VT 05060-1330. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Kotelchuck, Shana can be contacted via phone (802) 728-4466.Contact Information
Primary practice address
11 S Main St
Randolph VT 05060-1330
Phone: (802) 728-4466
Fax: (802) 728-4197
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 089-0001123 | Vermont |
Profile Details
| NPI number | 1073648895 |
|---|---|
| LBN Legal business name | Kotelchuck, Shana |
| Credentials | LICSW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 22nd, 2007 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073648895 | NPPES |
| Vermont | MEDICAID | 1013367 |
Popular Providers
-
Hillard, Gary D.
2 S Main St , Randolph VT 05060-1367 -
Sugarman, Nathalie C
11 N Main St , Randolph VT 05060-1126 -
Young, Emily
44 S Main St , Randolph VT 05060-1381 -
Campbell, Jenni Marie
11 N Main St Po Box G, Randolph VT 05060-1126 -
Grant, John H.
291 Wall St. , Kingston NY 12401-3849 -
Sargent, Alexis J
11 N Main St , Randolph VT 05060-1126 -
Briggs, Kristen
11 N Main St , Randolph VT 05060-1126 -
Tautfest, James
44 S Main St , Randolph VT 05060-1381